The candidate, Vijay Nambi, M.D., is a clinician trained in adult cardiology and vascular medicine who is currently an Assistant Professor (tenure track) in the Department of Medicine, Section of Atherosclerosis and Vascular Medicine at Baylor College of Medicine, Houston, Texas. The candidate's long term goal is to become an established independent investigator in the field of atherosclerosis and preventive cardiology. In order to achieve his stated goal, he has enrolled in the clinical scientist training program and is currently working towards a Ph.D. in clinical research with formal mentoring by a Ph.D. advisory committee. The K-23 career development award will provide the candidate with the opportunity to pursue research studies aimed at improving cardiovascular risk prediction using novel biomarkers, genotyping and imaging with a focus on application of new advances in ultrasound imaging technology to improve the evaluation of atherosclerosis with potential future application in cardiovascular risk assessment and management. Although existing methods to evaluate cardiovascular risk such as the Framingham risk scores are good, they fail to identify several individuals who develop cardiovascular disease. Under the guidance of Dr. Ballantyne and an outstanding group of advisors, the candidate proposes the following,specific aims aimed at improving cardiovascular disease risk prediction: 1. Evaluate whether carotid initima media thickness (C-IMT) and presence of plaque can improve cardiovascular (coronary heart disease [CHD] and stroke) risk prediction 2. Evaluate whether the addition of single nucleotide polymorphism (rs1333049) in chromosome 9p21 (known to be associated with CHD) to C-IMT will further improve CHD risk prediction 3. Evaluate whether ex-vivo and in-vivo 3-dimensional ultrasound imaging can reliably estimate atherosclerotic plaque volume and composition when compared to magnetic resonance imaging and histology and 4. Evaluate whether carotid artery stiffness is associated with incident CHD and stroke in the ARIC study and whether carotid artery strain can be reliably measured by adapting novel echocardiography-based technology to carotid ultrasound imaging. RELEVANCE (See instructions): This research is of significant public health importance. The ability to improve cardiovascular disease risk prediction may allow for timely interventions that decrease the incidence of cardiovascular disease, the leading cause of death in the western world. (End of Abstract)